Johnson and Johnson vaccine could offer US a third vaccine as new variants complicate pandemic

If you go by the numbers alone, the Johnson and Johnson vaccine does not hit it out of the park are preventing mild coronavirus infection like the Pfizer-BioNTech and Moderna vaccines did in clinical trials.

But, the physician who led the team that developed the J&J vaccine, says it was tested later in the pandemic, as new more transmissible variants began to complicate things.

Dr. Dan Barouch, Director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center in Boston, says he believes the vaccine delivers on its promise.

"It showed very good protection against moderate disease, but outstanding protection against severe disease and complete protection against hospitalizations and death, which is really the primary goal of the vaccine," Barouch says.

In large scale studies, the J&J vaccine was 66% effective worldwide and 72% effective in the US at preventing mild to moderate COVID-19, compared to the Pfizer-BioNTech and Moderna vaccines, which were up 90 and 95% effective.

But Dr. Barouch,a professor at Harvard Medical School, says the J & J vaccine was studied not just in the US, but in viral hotspots such as Latin America and South Africa, as new variants emerged.

It proved 85% effective at preventing more severe disease, and 100% effective at preventing hospitalizations and deaths in the volunteers who received the vaccine.

"Right now, in Brazil and South Africa, we have a large fraction of the viruses are these so-called resistant variants," Dr. Barouch says.  "Demonstrating that this vaccine protects very well against these highly resistant variants is a very, very good sign."

The J&J vaccine uses a deactivated cold virus as a Trojan horse to deliver the coronavirus' spike protein's DNA into cells, teaching the body how to produce the protein needed to generate an immune response that protects against the virus.

Microbiologist Dr. Amber Schmidtke, Ph.D., says the Johnson and Johnson vaccine is also a one-shot vaccine that doesn't require deep freezer storage, which could simplify the rollout.

"I think this vaccine will be a game-changer for places like rural Georgia and medically underserved populations, where it's harder to store the vaccines that have the two-dose series.  But, also, we don't have to follow up with them to get their second dose on board."

Schmidtke thinks the gap in effectiveness between the J & J vaccine and the first two FDA-approved vaccines is an artifact of when the vaccines were tested during the pandemic.

"So, I would caution people not to try to shop around necessarily when it comes to which vaccine they want to get," Schmidtke says.  "Honestly, I would just take the very first one that is made available to you."

An independent FDA advisory panel will meet February 26, 2021 to review the J & J study data and make a recommendation on the vaccine.

If Johnson and Johnson receives emergency approval, the company says it could begin shipping vaccine in March. 

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